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General NPI Number Information
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NPI Number | 1801415690
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Entity Type | Organization
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Legal Business Name | NORTH STAR ABDOMINOPELVIC PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 04/11/2020
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Last Update Date | 04/11/2020
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Provider Practice Location Address
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Address Line | 1475 HERITAGE PKWY STE 121
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City | MANSFIELD
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State | TX
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Zip | 76063-2739
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Country | US
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Telephone | 817-405-9502
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Fax | 844-416-9334
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Provider Business Mailing Address
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Address Line | 2229 CANCUN DR
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City | MANSFIELD
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State | TX
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Zip | 76063-8549
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | TINA CHANEY
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Credential |
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Telephone | 817-913-0150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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